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CITY OF SANTA ANA <br />RFP NO.: 22-096 <br />ON CALL EMERGENCY ASPHALT & PCC <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA ) <br />Nezar Alsmadi, President being duly sworn, deposes and says: <br />❑ INDIVIDUAL <br />❑ PARTNERSHIP <br />That he/she is the party making the foregoing proposal: <br />That he/she is a member of the co -partnership firm designated as: <br />and who has been and is duly vested with the authority to make and execute instruments for the co -partnership <br />by: <br />who constitute the other members of the co -partnership. <br />[gCORPORATION That he is of: We R Builders, Inc. <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VLNTURE That he is of: <br />one of the parties making the foregoing proposal as a joint venture, and the he/she has been and is duly vested <br />with the authority to execute instruments for an on behalf of the parties making said bid who are: <br />that such a bid is genuine and not collusive or sham, and has not in any manner sought by collusion to secure any <br />advantage against the City of Santa Ana or any person interested in the proposed contract, for himself or any other <br />person. <br />Simlat e of CONTRACTOR <br />S0i scribed a­P*-,,,,w#rn to b—efure, hw-411is <br />Si <br />6th <br />day of.' <br />ota`ry Public) <br />February 20 23 <br />NATALIA ELIZABETH FLORES <br />e- COMM.#233867B <br />Z LOSANGELES COUNTY <br />aq NOTARY PUBt.IC-CALIFOPIN1 <br />MY COMMISSION EXPIRES <br />NOVEMBER 27. 2024 <br />Page 3 of 10 <br />